Request Assistance

For Church Leaders and Ministry Representatives

If you are seeking assistance for a member of your congregation, please complete the form below. All requests are handled with confidentiality, prayer, and care.

NOTE

All assistance requests must be submitted by a church or ministry leader.

Our mission is to assist those in need seamlessly.

We prioritize helping those walking difficult paths.

Together we create solutions for community challenges.

Through faith, we act boldly when others cannot.

Financial Assistance Request Form

All information provided will be kept confidential and used solely to determine eligibility for assistance.

Applicant Information

First name

Last name

Phone

Multi-line address

Country/Region

Address

City

Zip / Postal code

Church Information

Name of current church

Name of Pastor or Church Leader

Multi-line address

Country/Region

Address

City

Zip / Postal code

How many years have you attended this church?

Financial Assistance Request

Amount of Financial Assistance Requested:

Briefly explain the purpose of this request and your current financial need:

Personal Statement & Christian Journey

Please tell us a little about yourself, your current situation, and your Christian journey. Include how your faith has guided you during this time:

Declaration & Signature

I certify that the information provided in this application is true and accurate to the best of my knowledge. I understand that submission of this application does not guarantee financial assistance.

Signature

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